Preference for Face-to-Face Contraceptive Service Delivery Post-COVID-19 Pandemic : Cross-Sectional Study

Objective To measure the prevalence of, and social positions associated with, preference for solely face-to-face contraceptive service delivery among women and people assigned female at birth in post-COVID-19 pandemic England. Design Cross-sectional online study. Setting England. Sample The Reproductive Health Survey for England (RHSE) recruited women and people assigned female at birth aged 16–55 living in England using an online non-probability convenience sampling strategy from September–October 2023. The study population was limited to contraception users who answered the question of interest. Methods Multivariable logistic regression identified variables independently associated with preference for face-to-face services. Main Outcome Measures Preference for face-to-face services, derived from response to the question ‘How would you prefer to access contraceptive services?’ (face-to-face vs. telephone/video/website/combination/no preference). Results The study population included 28 328 participants: median age was 30 (IQR:24–38), 92.5% (n = 26 193) reported White ethnicity, and 96% (n = 27 296) identified as a woman/girl. Preference for solely face-to-face services services was reported by 24.7% (n = 6992/28 328). In adjusted analysis, preference for face-to-face was associated with younger and older age; not having degree-level qualifications, self-reporting financial hardship, living with a disability, identifying as a woman/girl, and not being in a (cohabiting) relationship. Whilst there was a significant independent association between paid employment and preference for face-to-face services, effect direction was dependent on ethnicity. Conclusions Although a minority of participants reported a preference for solely face-to-face services, they may represent those with the highest unmet need for contraceptive services. Maintaining choice within contraceptive service delivery in an increasingly digitised healthcare landscape is crucial to advance equitable, person-centred reproductive healthcare.